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a branch of clinical medicine concerned with diseases of the large intestine, including the rectum.
Proctology was formed as an independent medical specialty on the basis of advances made in several clinical disciplines. Proctologic patients are treated by surgeons, specialists in internal medicine (gastroenterologists), and specialists in infectious diseases. Delineation of the subject area of proctology varies in different countries. According to the most prevalent view, proctology is the study of diseases of the rectum (such as fistulas, anal clefts, hemorrhoids, proctitis, and cancer) and of various noninfectious disorders of the large intestine. The latter include chronic inflammatory disorders, such as nonspecific ulcerative, granulomatous, and catarrhal forms of colitis; functional disorders, for example, constipation; and benign and malignant tumors.
Proctologic diseases were described by many ancient and medieval physicians, such as Hippocrates, Celsus, and Avicenna. The first specialized books on proctology were published in the second half of the 19th century—in Russia, Guide to the Study and Treatment of Diseases of the Rectum and Anus by I. G. Karpinskii in 1870, and in Great Britain, Surgery of the Rectum by G. Smith in 1876. The first specialized medical institution for proctologic patients, St. Mark’s Hospital, was opened in London in 1835. Early in the 20th century, specialized clinics and hospitals were organized in the United States and then in France, Denmark, Belgium, Spain, and other countries. The development of proctology is associated with H. Lockhart-Mummery and William E. Miles of Great Britain, Joseph M. Matthews of the United States, and J. A. E. E. Quénu and H. Hartmann of France.
In Russia, proctologic patients were treated in general surgical hospitals that specialized in proctology and by departments of general hospitals. The work of S. P. Fedorov and V. R. Braitsev promoted the improvement of the diagnosis and treatment of proctologic diseases. In the 1950’s specialized departments of proctology were organized on the initiative of A. N. Ryzhikh in Moscow and A. M. Aminev in Kuibyshev. Major scientific schools, the main centers for the training of proctologists, formed in connection with these departments. Courses in proctology are also presently available at some institutes for postgraduate medicine. As of 1973, there were 25 specialized departments of proctology in the USSR and 230 polyclinics with facilities for providing specialized outpatient care for proctologic patients. The leading proctologic research and treatment facility in the USSR is the Moscow Proctology Laboratory and Clinic of the Ministry of Health of the RSFSR, organized in 1965. It has five specialized clinical departments, a diagnostic laboratory, and administrative sections. Studies on proctology are published in the journal Khirurgiia (Surgery; Moscow, since 1925) and Vestnik khirurgii im. I. I. Grekova (I. I. Grekov Review of Surgery; Leningrad, 1885).
The leading foreign journals on proctology are American Journal of Proctology (New York, 1950) and Diseases of the Colon and Rectum (Philadelphia, 1958). Proctologists in various countries have combined to form the International Academy of Proctology, which has sponsored annual congresses since 1949, and the International Society for the Study of Diseases of the Colon and Rectum, which has held congresses every two years since 1964.
REFERENCESBraitsev, V. R. Zabolevaniia priamoi kishki. Moscow, 1952.
Aminev, A. M. Rukovodstvo po proktologii, vols. 1–3. Kuibyshev, 1965–73.
Ryzhikh, A. N. Atlas operatsii na priamoi i tolstoi kishkakh, 2nd ed. Moscow, 1968.
Hillemand, P., A. Bensaude, and J. Loygue. Les Maladies de l’anus et du canal anal. Paris, 1955.
Hughes, E. S. R. Surgery of the Anus, Anal Canal and Rectum. Edinburgh-London, 1957.
Goligher, J. C. Surgery of the A nus, Rectum and Colon. London, 1961.
Mayo, C. W. Surgery of the Small and Large Intestine, 2nd ed. Chicago, 1962.
Gabriel, W. B. The Principles and Practice of Rectal Surgery, 5th ed. London, 1963.
V. D. FEDOROV